Suprarenal Fixation: Effect on Blood Flow of an Endoluminal Stent Wire across an Arterial Orifice

2003 ◽  
Vol 10 (2) ◽  
pp. 260-274 ◽  
Author(s):  
Kurt Liffman ◽  
Michael M.D. Lawrence-Brown ◽  
James B. Semmens ◽  
Ilija D. Šutalo ◽  
Anh Bui ◽  
...  

Purpose: To investigate what effect, if any, the presence of a stent wire in front of a renal artery has on the volume flow rate of blood through the renal artery. Methods: Experimental, numerical, and analytical modeling methods were used to test 4 separate stent wire configurations: a stent wire across the center of an artery orifice, an off-center wire placed at one-quarter the arterial diameter, a V-shaped wire with its vertex at the center, and 2 stent wires at one-third-diameter spacing. Results: For all the configurations studied, the presence of stent wires has a minimal effect on the blood flow rate into an artery of ≥3-mm diameter, with most flow rates decreasing by around 1%. This is true provided that there is no buildup of material on the wire. When material buildup was “encouraged” to occur, then decreases in flow rate of up to 40% were observed. The numerical and analytical methods indicated that the flow rates would, in most cases, decrease by around 3% to 10%. Conclusions: A bare stent wire in front of a >3-mm-diameter artery decreases the flow rate minimally, providing there is no material on the wire. Although the numerical and analytical methods indicated a greater effect on flow, the approximations required for these 2 methods to obtain meaningful solutions suggest that the experimental results are the most accurate. Nonetheless, the analytical equations provided a useful approximation for determining the effect on blood flow due to the presence of a stent wire.

1983 ◽  
Vol 6 (3) ◽  
pp. 127-130 ◽  
Author(s):  
C. Woffindin ◽  
N.A. Hoenich ◽  
D.N.S. Kerr

Data collected during the evaluation of a series of hemodialysers were analysed to see the effect of hematocrit on the clearance of urea and creatinine. All evaluations were performed on patients with a range of hematocrits with a mean close to 20%. The urea clearance of those in the upper half of the distribution curve (mean hematocrit 29.4%) was not significantly different from that of patients in the lower half of the distribution curve (mean hematocrit 16.9%) whether the clearance was studied at high or low blood flow rates and with hollow fibre or flat plate disposable hemodialysers. Likewise, there was no correlation between hematocrit and urea clearance by regression analysis. In contrast, the clearance of creatinine was affected by hematocrit being greater at lower hematocrit values. This difference was independent of blood flow rate and dialyser type and was confirmed by regression analysis.


2021 ◽  
Vol 12 ◽  
Author(s):  
M G Vossen ◽  
S Pferschy ◽  
C Milacek ◽  
M Haidinger ◽  
Mario Karolyi ◽  
...  

Background: Elimination of a drug during renal replacement therapy is not only dependent on flow rates, molecular size and protein binding, but is often influenced by difficult to predict drug membrane interactions. In vitro models allow for extensive profiling of drug clearance using a wide array of hemofilters and flow rates. We present a bovine blood based in vitro pharmacokinetic model for intermittent renal replacement therapy.Methods: Four different drugs were analyzed: gentamicin, doripenem, vancomicin and teicoplanin. The investigated drug was added to a bovine blood reservoir connected to a hemodialysis circuit. In total seven hemofilter models were analyzed using commonly employed flow rates. Pre-filter, post-filter and dialysate samples were drawn, plasmaseparated and analyzed using turbidimetric assays or HPLC. Protein binding of doripenem and vancomycin was measured in bovine plasma and compared to previously published values for human plasma.Results: Clearance values were heavily impacted by choice of membrane material and surface as well as by dialysis parameters such as blood flow rate. Gentamicin clearance ranged from a minimum of 90.12 ml/min in a Baxter CAHP-170 diacetate hemofilter up to a maximum of 187.90 ml/min in a Fresenius medical company Fx80 polysulfone model (blood flow rate 400 ml/min, dialysate flow rate 800 ml/min). Clearance of Gentamicin vs Vancomicin over the F80s hemofilter model using the same flow rates was 137.62 mL vs 103.25 ml/min. Doripenem clearance with the Fx80 was 141.25 ml/min.Conclusion: Clearance values corresponded very well to previously published data from clinical pharmacokinetic trials. In conjunction with in silico pharmacometric models. This model will allow precise dosing recommendations without the need of large scale clinical trials.


1983 ◽  
Vol 3 (3) ◽  
pp. 369-375 ◽  
Author(s):  
S. Nakamura ◽  
G. M. Hochwald

The effect of changes in brain blood flow on cerebrospinal fluid (CSF) volume flow rates, and that of changes in CSF volume flow rates on brain blood flow were determined in both normal and kaolin-induced hydrocephalic cats. In both groups of cats, blood flow in grey and white matter, cerebral cortex, and choroid plexus was measured with 105Ru microspheres during normocapnia, and again with 141Ce microspheres after arterial Pco2 was either increased by 300% or decreased by 50%. Blood flow measurements were also made during perfusion of the ventricular system with mock CSF and repeated during perfusion with anisosmotic mannitol solutions to alter CSF volume flow rate. In 30 normal and 26 hydrocephalic cats, blood flow to the cerebral cortex, white matter, and choroid plexus was similar; only blood flow to the caudate nucleus was greater in normal cats. The weight of the choroid plexus from hydrocephalic cats decreased by 17%. Blood flow in the choroid plexus of all cats decreased by almost 50% following hypercapnia or hypocapnia, without a change in the CSF volume flow rate. There was no change in cerebral or choroidal blood flow when CSF volume flow rate was either increased by 170% or decreased by 80%. These results suggest that choroid plexus blood flow does not limit or affect the volume flow rate of CSF from the choroid plexus. CSF volume flow rate can be altered without corresponding blood flow changes of the brain or choroid plexus. Choroid plexus blood flow and the reactivity of both brain and choroidal blood flow to changes in arterial Pco2 were not affected by the hydrocephalus. The lower CSF formation rate of hydrocephalic cats can be attributed in part to the decrease in the mass of choroid plexus tissue.


2007 ◽  
Vol 106 (6) ◽  
pp. 1051-1060 ◽  
Author(s):  
Prem Venugopal ◽  
Daniel Valentino ◽  
Holger Schmitt ◽  
J. Pablo Villablanca ◽  
Fernando Viñuela ◽  
...  

Object Due to the difficulty of obtaining patient-specific velocity measurements during imaging, many assumptions have to be made while imposing inflow boundary conditions in numerical simulations conducted using patient-specific, imaging-based cerebral aneurysm models. These assumptions can introduce errors, resulting in lack of agreement between the computed flow fields and the true blood flow in the patient. The purpose of this study is to evaluate the effect of the assumptions made while imposing inflow boundary conditions on aneurysmal hemodynamics. Methods A patient-based anterior communicating artery aneurysm model was selected for this study. The effects of various inflow parameters on numerical simulations conducted using this model were then investigated by varying these parameters over ranges reported in the literature. Specifically, we investigated the effects of heart and blood flow rates as well as the distribution of flow rates in the A1 segments of the anterior cerebral artery. The simulations revealed that the shear stress distributions on the aneurysm surface were largely unaffected by changes in heart rate except at locations where the shear stress magnitudes were small. On the other hand, the shear stress distributions were found to be sensitive to the ratio of the flow rates in the feeding arteries as well as to variations in the blood flow rate. Conclusions Measurement of the blood flow rate as well as the distribution of the flow rates in the patient's feeding arteries may be needed for numerical simulations to accurately reproduce the intraaneurysmal hemodynamics in a specific aneurysm in the clinical setting.


2007 ◽  
Vol 8 (4) ◽  
pp. 252-257 ◽  
Author(s):  
F. Techert ◽  
S. Techert ◽  
L. Woo ◽  
W. Beck ◽  
H. Lebsanft ◽  
...  

Background Higher blood flow in dialysis therapy is often avoided due to concerns about shear-induced blood damage despite the lack of reliable data. Objective This study investigated the influence of higher blood flow rates on plasma free hemoglobin (Hb) concentration after hemodialysis (HD) treatment. Methods Thirty-two chronic HD patients were treated once with a blood flow rate of 250 mL/min using a 17G needle, and once with a blood flow rate of 500 mL/min using a 14G needle. Arterial and venous pressure and blood pressure (BP) were recorded before and after treatment. Blood samples were taken before and after treatment for analysis of plasma free Hb, pH, HCO3, base excess, hematocrit value, urea, sodium, potassium and calcium. Results HD treatment at blood flow rates of 500 mL/min did not increase plasma free Hb compared to treatments at blood flow rates of 250 mL/min. Frequency of intradialytic BP drops was not different either. By adaptation of the needle size, negative arterial pressure could be kept at a similar level. Urea reduction rates were significantly higher during treatments with higher blood flow rates. Conclusion Higher blood flow rates can be applied without an increased hemolysis risk provided that needle sizes are adapted accordingly.


1991 ◽  
Vol 261 (2) ◽  
pp. H271-H279 ◽  
Author(s):  
C. D. Fike ◽  
M. R. Kaplowitz

The purpose of this study was to determine whether increased pulmonary blood flow and/or the history of pulmonary blood flow alters microvascular pressures in lungs of newborns. Using the direct micropuncture technique, we measured pressures in 20- to 60-microns-diameter arterioles and venules in isolated lungs of newborn rabbits at consecutive blood flow rates of 50 (baseline), 100, and/or 200 ml.min-1.kg-1. Then in some lungs we returned blood flow rate to baseline and repeated microvascular pressure measurements. We kept left atrial pressure the same at all blood flow rates. When blood flow rate increased and left atrial pressure was maintained constant, pulmonary arterial, 20- to 60-microns-diameter arteriolar, and 20- to 60-microns-diameter venular pressures increased such that the percentage of total pressure drop that occurred across veins increased. When we returned blood flow to baseline, venular pressure returned to baseline, but arteriolar and pulmonary arterial pressures returned to values less than baseline so that the percentage of the total pressure drop that occurred across microvessels decreased. Thus both blood flow rate and blood flow history are important determinants of the longitudinal distribution of pulmonary vascular pressures across newborn lungs. These findings also suggest that in newborn lungs venules greater than 60 microns diameter are poorly distensible such that higher blood flow rates result in increased microvascular pressures. Hence, under conditions of increased pulmonary blood flow, such as occurs with left to right shunts, the tendency for edema formation will increase in newborn lungs even if left atrial pressure does not increase.


1976 ◽  
Vol 231 (3) ◽  
pp. 961-966 ◽  
Author(s):  
WR Chenitz ◽  
BA Nevins ◽  
NK Hollenberg

Glomerular blood flow in the rat, measured with radioactive microspheres, averaged 233 +/- 59 nl/min per glomerulus, significantly less than the glomerular flow rate in the dog (568 +/- 115; P less than 0.005). The difference in glomerular blood flow rate could not be attributed to differences in mean or cortical flow rates, the fraction of acrdiac output received, cardiac output normalized to body weight, or the fractional distribution of blood flow or glomeruli from outer to inner cortex in the two species. The size of microspheres reaching the glomerulus, however, was significantly larger in the dog than in the rat (P less than 0.0005) suggesting that afferent arterioles were larger in the dog than rat. The difference in afferent resistance calculated from the size of microspheres delivered to the glomeruli was larger than the difference in glomerular blood flow. With a similar arterial pressure, a lower afferent resistance suggests a higher glomerular capillary pressure in the dog, consistent with a number of suggestions that filtration equilibrium is less likely in this species.


2017 ◽  
pp. S529-S536 ◽  
Author(s):  
D. JANÁK ◽  
P. HÁLA ◽  
M. MLČEK ◽  
M. POPKOVÁ ◽  
S. LACKO ◽  
...  

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a method used for the treatment most severe cases of decompensated heart failure. The purpose of this study was to evaluate the risk of the formation of microembolisms during VA-ECMO-based therapy. Heart failure was induced with simultaneous detection of microembolisms and the measurement of blood flow rate in the common carotid artery (CCA) without VA-ECMO (0 l/min) and at the VA-ECMO blood flow rate of 1, 2, 3 and 4 l/min. If embolisms for VA-ECMO 0 l/min and the individual regimes for VA-ECMO 1, 2, 3, 4 l/min are compared, a higher VA-ECMO flow rate is accompanied by a higher number of microembolisms. The final microembolism value at 16 min was for the VA-ECMO flow rate of 0 l/min 0.0 (0, 1), VA-ECMO l/min 7.5 (4, 19), VA-ECMO 2 l/min 12.5 (4, 26), VA-ECMO 3 l/min, 21.0 (18, 57) and VA-ECMO 4 l/min, 27.5 (21, 64). Such a comparison is statistically significant if VA-ECMO 0 vs. 4 l/min p<0.0001, 0 vs. 3 l/min p<0.01 and 1 vs. 4 l/min p<0.01 are compared. The results confirm that high VA-ECMO flow rates pose a risk with regards to the formation of a significantly higher number of microemboli in the blood circulation and that an increase in blood flow rates in the CCA corresponds to changes in the VA-ECMO flow rates.


1972 ◽  
Vol 50 (8) ◽  
pp. 774-783 ◽  
Author(s):  
Serge Carrière ◽  
Michel Desrosiers ◽  
Jacques Friborg ◽  
Michèle Gagnan Brunette

Furosemide (40 μg/min) was perfused directly into the renal artery of dogs in whom the femoral blood pressure was reduced (80 mm Hg) by aortic clamping above the renal arteries. This maneuver, which does not influence the intrarenal blood flow distribution, produced significant decreases of the urine volume, natriuresis, Ccreat, and CPAH, and prevented the marked diuresis normally produced by furosemide. Therefore the chances that systemic physiological changes occurred, secondary to large fluid movements, were minimized. In those conditions, however, furosemide produced a significant increase of the urine output and sodium excretion in the experimental kidney whereas Ccreat and CPAH were not affected. The outer cortical blood flow rate (ml/100 g-min) was modified neither by aortic constriction (562 ± 68 versus 569 ± 83) nor by the subsequent administration of furosemide (424 ± 70). The blood flow rate of the outer medulla in these three conditions remained unchanged (147 ± 52 versus 171 ± 44 versus 159 ± 54). The initial distribution of the radioactivity in each compartment remained comparable in the three conditions. In parallel with the results from the krypton-85 disappearance curves, the autoradiograms, silicone rubber casts, and EPAH did not suggest any change in the renal blood flow distribution secondary to furosemide administration.


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